District level Facility based surveillance for COVID-19

Background
 There is a need to establish systematic surveillance for SARS-CoV-2 infection in all
districts of country. This surveillance will be in addition to the routine testing as per current
testing guidelines.
 Besides the facility based surveillance, ICMR/NCDC in collaboration with key stakeholders
and state health departments is initiating a population based sero-survey in selected
districts representing the case detection across the country.

Objective
 Monitor the trend in prevalence of SARS-COV2 infection at district level

Methods
 Surveillance unit: district
o From each district, 10 health facilities (including 6 public and 4 private health
facilities should be selected)

 Population groups:
o Low risk population: Outpatient attendees (non-ILI patients) and pregnant women
o High risk population: health care workers,

 Sample size and frequency of sample collection:

Sentinel Group Samples per Samples per
District per District per
Week Month
High risk
Healthcare workers 100 400
Low risk
Outpatient attendees (Non-ILI patients) 50 200
Pregnant women 50 200
Total 200 800

 Laboratory test and pooling:

o Throat/nasal swabs to be collected for RT-PCR tests
o Samples should be tested in a onetime pool of 25. Results of this sample pooling
is only for surveillance purposes. It should not be used for diagnosis of individual
patients.
o In addition to throat/nasal swabs, blood samples should be collected for detecting
IgG antibodies for ELISA testing.
o In subsequent rounds, IgG ELISA based testing of serum samples will replace
RTPCR based testing for surveillance purpose.

 Data collection and analysis:

o Data on demographic characteristics will be collected on a specifically designed
standard data collection form using ODK platform.
o The data will be analyzed locally for action using standard indicator formats.
Indicators for person, place, time and trend analysis will be made.
o Data collation and dissemination will take place as decided jointly by ICMR and
DoHFW.

 Implementation partners:
o District and State health administrative, IDSP, NCDC, ICMR institutes, community
medicine departments of medical colleges and public health institutes.